Introduction. For proper management of anxious dental patients it is imperative to assess their levels of dental anxiety before treatment. Modified Dental Anxiety Scale (MDAS) is the most commonly used questionnaire to assess dental anxiety. But a Nepali version of MDAS is still lacking. Hence, the objective of this study was to develop a reliable and valid Nepali version of MDAS. Materials and Methods. The English version of the MDAS was translated into Nepali following a forward and backward translation process. Following pretesting and cognitive interviewing a final version of Nepali questionnaire was obtained. One hundred and fifty patients attending Department of Orthodontics completed the Nepali version of MDAS questionnaire at their convenience. Also, patients were asked to rate their overall anxiety on a 100 mm visual analog scale (VAS). A test-retest of the questionnaire was performed with 30 patients after 2 weeks. Results. Cronbach's alpha value of the Nepali version of MDAS was 0.775. The Intraclass Correlation Coefficient between test and retest was 0.872. Spearman's correlation coefficient between the total MDAS score and VAS score was 0.838. Conclusion. The translated Nepali version of MDAS is a reliable and valid instrument to measure the dental anxiety of Nepali patients.

BackgroundThe purpose of this study was to determine and compare the shapes, sizes, and bridging of the sella turcica in patients with different skeletal patterns and genders.MethodsIt was a cross-sectional comparative study. The samples were divided into three groups according to the skeletal pattern viz. Class I, Class II and Class III, and each group consisted of 40 samples (20 males and 20 females). The lateral cephalograms were traced and the sella turcica was assessed for its size, shape, and bridging.ResultsThe mean length, anteroposterior diameter and depth of sella turcica were 8.13 ± 2.03 mm, 9.60 ± 1.43 mm and 6.40 ± 1.21 mm respectively. The mean length of sella turcica was 7.91 ± 1.52 mm in Class I, 7.32 ± 1.62 mm in Class II and 9.16 ± .2.42 in Class III skeletal pattern; anteroposterior diameter was 9.30 ± 1.02 mm in Class I, 9.15 ± 1.28 mm in Class II and 10.35 ± 1.64 mm in Class III skeletal pattern; and the depth was 6.40 ± 0.92 mm in Class I, 6.07 ± 1.01 mm in Class II and 6.74 ± .1.54 mm in Class III skeletal pattern. There were significant differences in length and anteroposterior diameter and sella turcica between Class I, Class II and Class III skeletal patterns (p = 0.01), (p = 0.01) respectively. There was no significant difference in size of sella turcica between different genders and age groups. Sixty percent of the patients studied had normal Sella morphology. Partial Sella turcica bridging and Sella turcica bridging was seen in this study in 23.33% and 11.67% of patients respectively.ConclusionSixty percent of the patients had normal sella turcica. There were significant differences in lengths and anteroposterior diameters among Class I, Class II and Class III patients. The larger size was present in skeletal Class III patients.

Introduction Patients undergoing fixed orthodontic treatment are usually recalled electively for the adjustments of the appliances, but sometimes they appear suddenly for emergency visit which must be addressed immediately. The primary objective of this study was to assess the nature and frequency of emergency visits made by patients under labial fixed orthodontic therapy. The secondary objective was to compare these visits between genders and age groups. Materials and Methods The study was conducted at orthodontic clinic, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. All the patients undergoing fixed labial orthodontic treatment were included and followed up for a period of 6 months. The reason for emergency appointment was recorded along with the demographic and clinical details. Chi-square test was used to find out the possible association between gender and age group with emergency appointment. Results Of 327 patients undergoing active fixed orthodontic therapy, 199 were female and 128 were male. A total of 176 emergency appointments were encountered during the study period of 6 months. The most common reason was the loosening of brackets or bondable buccal tubes (118) followed by loosening of bands (45). Other reasons were trauma to the buccal mucosa by the overextended wire (5), detachment of buccal tubes from the band (5), tearing of bands (3), breakage of acrylic plate (2), loosening of ligature tie (1), and dislodgement of elastomeric chain (1). Emergency appointments were not found to have statistically significant association with age group (χ2 = 0.073, P = 0.787) or the gender (χ2 = 3.196, P = 0.074). Conclusions Loosening of the brackets or bondable buccal tubes was the most common cause for emergency visit. No significant association was found between the gender and age group with such visits.

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BackgroundPonticulus posticus is an anomaly of first cervical vertebra visible on lateral cephalogram and has some serious medical and surgical implications. Unfortunately, it is often overlooked or undetected by orthodontists. The general objective of this study is to sensitize orthodontists about this anomaly by depicting its prevalence among a group of Nepalese orthodontic patients.MethodsFour hundred and fourteen digital lateral cephalograms of orthodontic patients were retrieved from the archives of the department. The lateral cephalograms were carefully assessed for the presence of ponticulus posticus in the posterior spine of atlas vertebra by two investigators independently and the findings were recorded.ResultsPonticulus posticus was observed in 35.7% of the cases, of which 30.9% had partial ponticulus posticus and 4.8% had complete ponticulus posticus. Even though there was some female predilection, no statistically significant association was found between gender of the patient and presence of ponticulus posticus.ConclusionPonticulus posticus is a fairly common anomaly with more than one-third (35.7%) of a group of Nepalese orthodontic patients affected and is independent of gender. Since, this anomaly is associated with numerous medical conditions and has surgical implications, orthodontists should use lateral cephalogram as screening radiograph for this anomaly.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2494-z) contains supplementary material, which is available to authorized users.

Introduction: Measurement of the severity of malocclusion is assessed with various indices among which Index of Orthodontic Treatment Need (IOTN) is widely used for clinical and epidemiological purpose. Objective: To find out the treatment need of patients who are undergoing orthodontic treatment.Materials & Method: 207 patients (71 male, 136 female) fulfilling the inclusion criteria were assessed for the dental health component (DHC) and aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) by a single investigator. DHC was assessed with study models, whereas AC with intraoral frontal photograph.Result: Examination of DHC showed that 1 patient (0.5%) had no need; 20 patients (9.7%) had mild/little need; 50 patients (24.2%) had moderate/borderline need; 97 (46.9%) had severe need; 39 patients (18.8%) had extreme treatment need. Similarly, 7 patients (3.4%) had AC 1; 18 patients (8.7%) had AC 2; 13 patients (6.3%) had AC 3; 32 patients (15.5%) had AC 4; 34 patients (16.4%) had AC 5; 25 patients (12.1%) had AC 6; 18 patients (8.7%) had AC 7; 35 patients (16.9%) had AC 8; 15 patients (7.2%) had AC 9; 10 patients (4.8%) had AC 10.Conclusion: Among the patients who were undergoing orthodontic treatment, majority were in severe/extreme treatment need, however few with no treatment need were also found.Orthodontic Journal of Nepal, Vol. 6 No. 1, June 2016, pp.23-26

BackgroundMixed dentition space analysis methods using regression equations, namely, Moyers’ analysis and Tanaka-Johnston analysis are commonly used around the world. However, the applicability of these analyses among different racial groups have been questioned. The primary objective of this study was to assess the applicability of the Moyers’ and Tanaka-Johnston analyses among Nepalese Mongoloids and to develop regression equations for the same population if needed.MethodsOne hundred (50 males and 50 females) pre-treatment study models of the Nepalese Mongoloid patients undergoing orthodontic treatment were retrieved from the archives of the department of Orthodontics. The mesiodistal widths of mandibular incisors and widths of canines and premolars of all 4 quadrants were measured by a single investigator using a digital caliper to the nearest 0.01 mm. Predicted widths of canines and premolars were obtained using standard Moyers’ and Tanaka-Johnston analyses and then compared with the measured widths.ResultsThe measured widths of canines and premolars were significantly different from the predicted widths obtained from Moyers’ and Tanaka-Johnston analyses. Strong and positive correlations were found between the sum of mesiodistal widths of mandibular incisors and the sum of mesiodistal widths of canines and premolars in males (0.73 for maxillary arch and 0.68 for mandibular arch) and females (0.64 for maxillary arch and 0.79 for mandibular arch).ConclusionsThe Moyers’ and Tanaka-Johnston analyses did not accurately predict the mesiodistal width of unerupted canines and premolars for Nepalese Mongoloid population. Hence, new regression equations have been developed for this population. However, validation studies should be conducted to confirm the applicability and accuracy of these equations.Electronic supplementary materialThe online version of this article (10.1186/s12903-018-0677-1) contains supplementary material, which is available to authorized users.

Objective. This study aimed to find out the change in esthetic ratios during rotation of patient's head using a simulation. Materials and Methods. A plaster study model was photographed placing its midline along the long axis of the camera. Then a series of photographs were taken by rotating the model each degree till 10° on both right and left sides. These photographs were digitally measured and the ratio of the maxillary anterior teeth at zero-degree rotation was compared with that at various degrees of rotation. Results. As the model was rotated to the right side till 10°, the ratio of the right lateral to central incisor gradually decreased while the ratio of the left lateral to central incisor gradually increased. However, the ratio of the canine to lateral incisor on both sides gradually increased. Similar results were obtained when the model was rotated to the left side. The ratio of the lateral to central incisor deviated from the acceptable range (±10%) when there was rotation of more than 7°, whereas the ratio of the canine to lateral incisor was within the acceptable range till 10° rotation on either side. Conclusions. Rotation of the model by more than 7° leads to a substantial change in the esthetic ratio.